Session Descriptions

The course is organized around ten sessions. Each session focuses on the latest research into the causes, prevention and treatment of a particular aspect of addiction. The goal of each session is to translate research findings into clinically useful knowledge.

Session Descriptions

Session 1: Prescription Opioids: Misuse, Consequences and Countermeasures

Organizers: Frank J. Vocci, PhD, Chair, Melinda M. Campopiano, MD, David A. Fiellin, MD, Edwin A. Salsitz, MD, DFASAM

Explore the extent of the current prescription opioid epidemic, the current transition to heroin, prescribing guidelines for opioid therapy for chronic pain, the evidence base for the risk/benefit of opioids for treating chronic pain, the use of agonist medication for medication assisted withdrawal and management of Opioid Use Disorder in pregnant women, and maternal, fetal, neonatal and child outcomes associated with opioid agonist therapy.

Session 2:  Opioid Use Disorder: Acute and Long Term Treatment Issues

Organizers: Frank J. Vocci, PhD, Chair, Melinda M. Campopiano, MD, David A. Fiellin, MD, Edwin A. Salsitz, MD, DFASAM

Medications for treating various aspects of Opioid Use Disorder include the use of agonists, partial agonists, and antagonists.  Although medication assisted therapy is recognized as an effective strategy to manage Opioid Use Disorder, the decisions on duration of treatment and tapering strategies receives less attention.  Explore these issues and delve into managing Opioid Use Disorder with naltrexone, the selection of appropriate patients for this approach, and managing clinical issues that emerge during treatment with antagonists. The use of naloxone for prevention of overdose mortality and implementation of naloxone provision programs for lay persons will also be discussed.  The development of an opioid overdose-reversing intranasal formulation of naloxone for use by lay persons is also highlighted.

Session 3: Healthcare Delivery: From ACA to Your Practice

Organizers: Frank J. Vocci, PhD, Chair, David R. Pating, MD

Discover CONTINUUMTM, a computer assisted clinical interview and ASAM Criteria decision engine designed to conform to Federal health care reform requirements.  Understand the benefits of this program on patient flow, quality of care, revenues, staffing burden, prior authorization, and staff morale.  Focus will involve performance standards for physicians and how physicians can deliver quality health care while meeting the expectations of corporate and government entities.  This will involve a description of conflicts created by 42 CFR Part 2 and electronic health records, and accompanying rules governing private health information.  Examine changes in regulation and law designed to balance quality health care delivery with protection of privacy of patients seeking treatment for substance use disorders. 

Session 4: Guidelines for Treating Substance Use Disorders

Organizers: Frank J. Vocci, PhD, Chair, Ron R. Flegel, BS, MT(ASCP), MS, Edwin A. Salsitz, MD, DFASAM

Gain an overview of the development and recommendations of The ASAM National Practice Guideline for the Use of Medications in the Treatment of Addiction Involving Opioid Use.  Understand initiatives being implemented by the Department of Health and Human Services in response to the nation’s opioid overdose crisis. Also explore the national and international guidelines that address treatment needs of women in the perinatal period.

Session 5: Cannabinoids: Therapeutic Potentials & Medical Consequences

Organizer: Jag H. Khalsa, PhD, MS

Examine several topics in the field of cannabinoids.  An update on cannabis legalization will be followed by a presentation on the role of medical caregivers dispensing information on cannabis and its effects, and information on the unwanted effects of cannabinoid products.   A discussion of synthetic cannabinoids and new psychoactive substances and the illegal market that has proliferated will follow.  Discussion includes the evolving problems associated with this epidemic. For example, synthetic cannabinoids are not detected in conventional drug tests that assay for tetrahydrocannabinol, creating monitoring issues for criminal justice, highway safety, and medical personnel treating individuals under the influence of synthetic cannabinoids.  The last presentation reviews the current evidence of therapeutic potentials of cannabinoids and discusses efficacy outcome measures for possible clinical indications. 

Session 6: Weed in Your Workplace: What You Need to Know   

Organizer: Ron R. Flegel, BS, MT(ASCP), MS

SAMHSA’s guidance of implementing drug testing programs is utilized to explore the challenges of incorporating testing for synthetic and designer drugs of abuse into regulated testing. The proliferation of types and varieties of cannabis products, their effects on users, and potential effects of environmental exposure on non-users will be discussed. Discourse will include the dose effects of cannabis delivered by different routes of administration, and whether and to what degree biomarkers can inform cannabis-induced behavioral impairment. 

Session 7: New Issues in Medical Comorbidities

Organizers: Jag H. Khalsa, PhD, MS, Kathleen T. Brady, MD, PhD

Injection drug users have high rates of co-occurring infectious diseases. The first presentation describes the public health problem of Hepatitis C infection, changing demographics of the infected population, and ways to cure the infection in injection drug users.  The possibility of reinfection in injection drug users and the challenge it presents, along with diagnosis and management of neurocognitive changes brought on by HIV/HCV co-infection in aging patients with substance use disorders will be discussed.

Session 8: Updates on Psychiatric Comorbidities 

Organizers: Jag H. Khalsa, PhD, MS, Kathleen T. Brady, MD, PhD

Patients with a substance use disorder have a high prevalence of both lifetime and current psychiatric co-morbidities.  Analyze the prevalence of PTSD in patients with a substance use disorder, the neurobiology of PTSD, and its management by behavioral and pharmacological approaches.  Discourse includes the frequency, consequences and treatment of drug and alcohol use in patients with co-occurring bipolar disorder and schizophrenia. 

Session 9: Brain Imaging and Addiction: New Findings

Organizer: Frank J. Vocci, PhD, Chair

Magnetic Resonance Imaging (MRI) and functional MRI (fMRI) are discussed regarding their applications to phenomena in addiction medicine.  Following a description of the fMRI technique, imaging data will be presented showing brain changes associated with cognitive and affective mechanisms as an individual transitions to addiction.  Links between the genetics of addiction and imaging data will be analyzed.  Imaging correlates of smoking cues in smokers and their predictive validity to smoking cessation will be described.  Discussion covers functional, structural, and neurochemical evaluations of regions involved in cue-reactivity and craving.  Discourse will also include neural substrates of cannabis abstinence and the implication of these findings to treatment development.

Session 10: New Pharmacotherapies for Alcohol and Substance Use Disorders

Organizer: Raye Z. Litten III, PhD

The current pharmacotherapies for managing Alcohol Use Disorder (AUD) will be reviewed.  Highlights include the development of new pharmacotherapies that modulate brain stress systems to prevent symptoms leading to relapse as an adjunct to behavioral therapy.  Discussion will cover pharmacological management of AUD patients with liver disease.  A review of recent findings in the management of Opioid Use Disorder and novel strategies to deliver buprenorphine is included.